Mental status change in the elderly: Recognizing and treating delirium

Morency, Catherine R

doi:10.1016/s8755-7223(05)80128-0

Cited by 22 publications

(20 citation statements)

References 21 publications

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“…Theoretically, early detection of the causes of delirium enables the interdisciplinary team to treat the patient and as a result makes possible the prevention of further complications 5,12–14 . Yet delirium in older patients is frequently either overlooked, misdiagnosed or goes undocumented 15–19 …”

Section: Introductionmentioning

confidence: 99%

“…Lastly, as mentioned earlier, there might be a lack of awareness among the nursing profession of the clinical importance of delirium. Because cognitive state, and especially delirium, is not routinely tested in hospital, this undoubtedly contributes to under‐detection and the under‐documentation of delirium symptoms in medical charts 15,18,21 . Because of the fluctuating nature of delirium, documentation of its symptoms in nursing notes is paramount for diagnosing delirium 14 .…”

Section: Introductionmentioning

confidence: 99%

“…Because of the fluctuating nature of delirium, documentation of its symptoms in nursing notes is paramount for diagnosing delirium 14 . For example, detailed description in nursing notes of observed patient behaviours can help document a pattern of behaviour change that will assist greatly in establishing a diagnosis of delirium 18 . That being so, the terms used to describe the delirium symptoms are also important.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of nurse documentation of delirium symptoms in medical charts

Voyer

Cole

McCusker

et al. 2008

Int J of Nursing Practice

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The purpose of this study undertaken in an acute care hospital was to evaluate sensitivity and specificity of the documentation of nurse-reported delirium symptoms in medical charts. This is a descriptive study based on the clinical assessments of a study nurse and nursing notes in the medical charts of 226 delirious older patients newly admitted to an acute care hospital. The results of this prospective validation study indicated that documentation of delirium symptoms is poor. Disorientation, agitation and altered level of consciousness were the three symptoms yielding a higher level of sensitivity, but even so said symptoms were reported in less than a third of the medical charts. Univariate analysis suggested that higher comorbidity level, more severe symptoms of delirium and the use of physical restraints were associated with more valid documentation of delirium symptoms in medical charts. Lastly, this study corroborates results of previous studies, indicating that documentation of delirium symptoms in medical charts can be improved. Future study should target improving nurse documentation of delirium symptoms in medical charts.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Accuracy of nurse documentation of delirium symptoms in medical charts

Voyer

Cole

McCusker

et al. 2008

Int J of Nursing Practice

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“…We observed significantly lower administered doses of antipsychotic drugs in patients in the EG group, which lead us to conclude that exercise can be an effective delirium management strategy. Previous studies have shown that environmental and supportive interventions are highly effective in managing delirium [1,5,10,11,20,21,23]. The present study proposes exercise therapy as another valid option in the overall treatment strategy against delirium.…”

Section: Discussionmentioning

confidence: 74%

“…Intervention programs in these studies tend to include not only a treatment targeted to several risk factors but also environmental and supportive interventions. The overall aim of environmental and supportive interventions is to reduce as many risk factors for delirium as possible [23]. In addition to ongoing support provided by medical staff to maintain patient temporospatial orientation, preventing risk factors such as environmental changes, sleep deprivation, and immobility are all considered important precautions.…”

Section: Introductionmentioning

confidence: 99%

The effects of exercise therapy on delirium in cancer patients: a retrospective study

Tatematsu

Hayashi

Narita

et al. 2010

Support Care Cancer

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Creating avenues for relative empowerment (CARE): A pilot test of an intervention to improve outcomes of hospitalized elders and family caregivers

Liang

Melnyk

McCann

et al. 2003

Research in Nursing & Health

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The purpose of this pilot study was to evaluate the effectiveness of a family caregiver-focused intervention program (CARE) on the outcomes of hospitalized elders and their family caregivers. A randomized clinical trial was conducted with 49 family caregivers of hospitalized elders in a university medical center in upstate New York. Driven by self-regulation and role theories, the two-phase CARE program consisted of: (a). a mutual agreement consisting of family caregiving activities during hospitalization; and (b). audiotaped information regarding emotional responses and possible complications associated with an elderly patient's hospitalization as well as instructions for effectively participating in the elder's hospital care. The comparison program consisted of information about hospital services and policies. CARE elders had fewer incidents of acute confusion reported by family caregivers during hospitalization and fewer depressive symptoms at 2 weeks and 2 months posthospitalization than did the comparison group. CARE family caregivers participated more in the care of their hospitalized elders and had higher scores on role rewards prior to hospital discharge. Findings from this study support the need for further testing of the CARE intervention with family caregivers to determine its effectiveness on outcomes of hospitalized elders and their family caregivers.

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Mental status change in the elderly: Recognizing and treating delirium

Cited by 22 publications

References 21 publications

Accuracy of nurse documentation of delirium symptoms in medical charts

Accuracy of nurse documentation of delirium symptoms in medical charts

The effects of exercise therapy on delirium in cancer patients: a retrospective study

Creating avenues for relative empowerment (CARE): A pilot test of an intervention to improve outcomes of hospitalized elders and family caregivers

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